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Abstract：
BACKGROUND: There are no specific recommendations for the management of patients with bleeding disorders (BD), such as haemophilia A (HA), haemophilia B (HB), or von Willebrand disease (WD), in urology surgery. Methods: We conducted a retrospective study of 32 patients with HA, HB, or WD of any severity. Fifty-seven procedures were performed between January 2017 and September 2023. Surgical interventions were divided into two groups: those with and without electrocoagulation. The control patients were successively matched in a 2:1 ratio. Results: The study group consisted of 30 men and 2 women, with 23 HA, 2 HB, and 7 WD. The median age of the patients was 69 years. The BD group had a longer hospital stay of 4 days compared to 1 day (p < 0.0001). The incidence of bleeding events was 21% versus 2% (p < 0.0001), and the incidence of complications was 21% versus 7% (p = 0.0036) for Clavien 1-2 respectively. In the subgroup with intraoperative coagulation, the readmission rate at 30 days was higher (17% vs. 3%, p = 0.00386), as was the transfusion rate (17% vs. 3%, p = 0.0386). Conclusions: This study showed that urological procedures in patients with bleeding disorders were associated with a higher risk of bleeding and complications.
摘要：
背景：对于出血性疾病（BD）患者的治疗没有具体建议，如血友病A（HA），血友病B（HB），或vonWillebrand病（WD），在泌尿外科。方法：我们对32例HA患者进行了回顾性研究，HB,或任何严重程度的WD。在2017年1月至2023年9月期间进行了57次手术。手术干预分为两组：有和没有电凝法。对照患者以2：1的比例连续匹配。结果：研究组由30名男性和2名女性组成，23HA,2HB,7WD患者的中位年龄为69岁。与1天相比，BD组的住院时间更长，为4天（p<0.0001）。出血事件的发生率分别为21%和2%(p<0.0001),Clavien1-2的并发症发生率分别为21％和7％（p=0.0036）。在术中凝血的亚组中，30天的再入院率更高(17%vs.3%,p=0.00386),输血率也是如此(17%vs.3%,p=0.0386)。结论：这项研究表明，出血性疾病患者的泌尿外科手术与出血和并发症的风险更高。
